by Grant Mckenzie

Created on: February 25, 2009   Last Updated: February 26, 2009

The Diagnostic and Statistical Manual for Mental Disorders (DSM) lays out all the accepted symptoms for Bipolar Disorder. The problem with the manual is that it doesn't describe what experiencing those symptoms is like. Nor can it. People have asked me on many occasions about the symptoms of Bipolar Disorder, and when I describe them in clinical terms, the reaction is almost always the same - "Oh, I must be bipolar, then." The scary thing is that they mean it. That's when I tell them about the effects those symptoms have on the life of a bipolar like me.

Depression is the low side of Bipolar Disorder. According to the DSM, depression includes prolonged sadness, feelings of guilt, loss of energy, and social withdrawal, among other things. These are things most everyone will experience from time to time, but for a bipolar, it's much different. When I was in a deep depression, I slept for 12-16 hours per day. Even if I set an alarm clock, I could not wake up enough to get out of bed. When I did wake up, I lay awake trying to find any excuse, no matter how lame, not to kill myself that day. I believed that my life was not worth living and I lost all hope, but something remained hidden in the back of my mind that reminded me this feeling was not reality. If I did get up, I didn't leave my house. People always looked at me and immediately asked what was wrong. I didn't want to answer, mostly because I didn't know. So I stayed inside and thought about all the things that were wrong in my life. It wasn't a choice; it was the only thoughts my mind could bring up. This led to thoughts of suicide, and then plans, and then physically setting it up. It was a race to see if I would completely lose all my energy and involuntarily fall asleep or if I would take the action necessary to sleep forever.

Mania is just the opposite. The DSM uses phrases like grandiosity, increased activity, heightened mood, and impulsiveness. When I tell the story about the two weeks I spent awake, save about eight hours interspersed throughout, people changed their interpretation of "decreased need for sleep." When "impulsiveness" becomes a term of debate, I simply tell them about buying an expensive ring for a girl on our first date or driving five hours to the nearest ice skating rink because I felt like skating. Money and time lose all meaning in a manic high. Consequences either don't exist or don't apply. Hypersexuality is a symptom of mania, and with no fear of consequences, this can lead to broken relationships, emotional harm to yourself or others, or even physical harm.

When a bipolar experiences a mixture of depressive and manic symptoms, the results can be disastrous. When feelings of hopelessness and depression are combined with increased energy, the bipolar now has the energy and willpower to follow through on all those thoughts of suicide that are running through his mind. Racing thoughts and feelings of guilt lead to a form of paranoia. Mixed mania and depression usually results in irritable and sometimes violent behavior. People who are close to you are afraid of you because they cannot predict what you will do next. I have been overcome with the desire to beat a person senseless because they joked about my car being dirty, something I would have laughed at any other time. It's not rational and it's scary.

The clinical descriptions of bipolar symptoms are nice to have around and are a good tool for mental health professionals, but until you have looked into the mind of a bipolar, you can never truly appreciate their meaning.

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